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转移性胃肠道癌的接纳与承诺疗法:患者及照护者的质性研究

Acceptance and commitment therapy in metastatic gastrointestinal cancer: patient and caregiver qualitative study.

作者信息

Mosher Catherine E, Lewson Ashley B, Austin-Wright Miriam, Matthias Marianne S, Helft Paul R, Turk Anita A, Loehrer Patrick J, Sehdev Amikar, Al-Hader Ahmad A, Johns Shelley A

机构信息

Department of Psychology, Indiana University Indianapolis, Indianapolis, Indiana, USA

Department of Psychology, Indiana University Indianapolis, Indianapolis, Indiana, USA.

出版信息

BMJ Support Palliat Care. 2025 May 9. doi: 10.1136/spcare-2025-005548.

Abstract

OBJECTIVES

Acceptance and commitment therapy (ACT) is a promising behavioural intervention to improve quality of life in patients with advanced cancer and their family caregivers. Little qualitative research has examined the effects of ACT in cancer populations. Thus, this qualitative study examined the perceived impact of ACT, including mindfulness practice and values-based action, on patients with advanced gastrointestinal (GI) cancer and their family caregivers.

METHODS

Individual, semistructured qualitative interviews were conducted with 13 patients with stage IV GI cancer and 14 family caregivers following their participation in a six-session ACT intervention. Data were analysed using an immersion/crystallisation approach.

RESULTS

Most participants identified benefits of ACT that facilitated their adjustment to cancer or caregiving. Patients and caregivers described several effects of mindfulness, including improved management of fatigue and other symptoms, improved emotion regulation skills and an ability to savour the present moment. Some participants reported misperceptions of the purpose of mindfulness, such as emptying the mind of thoughts or relaxing. In addition, engaging in actions based on personal values often led to patient empowerment (eg, renewed sense of purpose in life), improved caregiver self-care and better relationship quality between patients and caregivers.

CONCLUSIONS

Results raise hypotheses about potential mechanisms and outcomes of ACT interventions that warrant examination. Findings also suggest that enhancing education on mindfulness in ACT interventions may reduce conceptual misunderstandings. Finally, results suggest that a dyadic ACT intervention may improve relationship functioning between family members.

摘要

目的

接纳与承诺疗法(ACT)是一种很有前景的行为干预方法,可改善晚期癌症患者及其家庭照顾者的生活质量。很少有定性研究考察ACT在癌症人群中的效果。因此,这项定性研究考察了ACT(包括正念练习和基于价值观的行动)对晚期胃肠道(GI)癌症患者及其家庭照顾者的感知影响。

方法

对13例IV期胃肠道癌症患者和14名家庭照顾者在参与为期六节的ACT干预后进行了个体、半结构化定性访谈。采用沉浸/结晶法对数据进行分析。

结果

大多数参与者确定了ACT的益处,这些益处有助于他们适应癌症或照顾工作。患者和照顾者描述了正念的几种效果,包括改善疲劳和其他症状的管理、提高情绪调节技能以及品味当下的能力。一些参与者报告了对正念目的的误解,比如清空思绪或放松。此外,基于个人价值观采取行动往往会增强患者的权能(如重新获得生活目标感)、改善照顾者的自我照顾以及改善患者与照顾者之间的关系质量。

结论

研究结果提出了关于ACT干预潜在机制和结果的假设,值得进一步研究。研究结果还表明,在ACT干预中加强对正念的教育可能会减少概念上的误解。最后,研究结果表明,二元ACT干预可能会改善家庭成员之间的关系功能。

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